effective first line treatment

Sep 3, 2003

Hi

What do you think of the regiman (first line) Kaletra, Viread and Emtreva? I have vl of 300K and tcells about 350. I appear to be a rapid progressor (neg test march 2002). I really don't want to start yet. I read on CDC guidlines Kaletra may cause fat distrubution problems. Also, after readong the July 2003 CDC report, it is not clear to me that treatment is recommended if tcells below 350 OR vl above 50K. The report is much less certain, no?

Response from Dr. Pierone

Hello, if you really don't want to start yet, you should definitely not start yet. Although your viral load is high, your CD4 cells are not in a dangerous range yet and you have time to gird your loins for eventual treatment. The closer someone's CD4 count gets to 200, the more nervous I get about watchful waiting. Below 200 CD4 cells, watchful waiting is not appropriate and medications should be started.

I think the first-line regimen of Kaletra, Viread (tenofovir) and Emtriva (FTC) is a good choice. My personal tendency is to use a non-nucleoside (nevirapine Viramune or efavirenz Sustiva) in first line regimens instead of Kaletra. Mainly because there are fewer pills, once daily option, and lower risk of metabolic complications (fat changes, lipid increases) with these regimens. I think Kaletra is a great medication, extremely potent, but tend to save it for later regimens in case of virologic failure.

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

The Body is a service of Remedy Health Media, LLC, 750 3rd Avenue, 6th Floor, New York, NY 10017. The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.